Screening for trauma exposure, and posttraumatic stress disorder and depression symptoms among mothers receiving child welfare preventive services

The role of parental trauma exposure and related mental health symptoms as risk factors for child maltreatment for parents involved with the child welfare (CW) system has received limited attention. In particular, little is known about the extent to which mothers receiving CW services to prevent maltreatment have experienced trauma and suffered trauma-related psychopathology. This study examined screening data collected from 127 mothers receiving CW preventive services. There were high levels of trauma exposure among screened mothers and their young children. Among mothers, 91.6% experienced at least one traumatic event (M = 2.60) and 92.2% reported their children had been exposed to one or more traumas (M = 4.85). Mothers reported high levels of trauma-related symptoms: 54.3% met probable criteria for posttraumatic stress disorder (PTSD) or depression (61.7%). Nearly half (48.8%) met criteria for co-morbid PTSD and depression. The large majority of the clients with trauma-related disorders were not receiving mental health services. Latina women had significantly more severe PTSD symptoms than African American women. Case planners reported that the screening process was useful and feasible. These findings underscore the feasibility and importance of trauma screening among parents receiving CW preventive services.     

Are Immigrant Youth Faring Better in U.S. Schools?1

In spite of the growing numbers and geographic dispersion of foreign‐born children, the school outcomes of foreign‐born teens improved during the 1990s. Analysis of Decennial Census data reveals that fewer immigrant youth dropped out of school and their English language proficiency improved. Some of the improvement is due to compositional change in the foreign‐born teen population. Levels of parental education increased over the decade. Poverty among foreign‐born adolescents declined. Other youth background characteristics did not change in a favorable direction. Multivariate analysis reveals that there was a large decline in the likelihood of immigrant teens dropping out of school above and beyond the demographic changes over the decade. For example, the likelihood that a Mexican‐born teen educated in U.S. schools drops out of school declined by an estimated 43 percent over the 1990s. There is little evidence, however, that U.S. schools have improved in their English language instruction over the decade.     

Trauma Focused Cognitive Behavioral Therapy with Children of Incarcerated Parents

This paper explores children’s trauma symptoms related to parental incarceration and lays the groundwork for the implementation of Trauma Focused Cognitive Behavioral Therapy (TF-CBT) within a clinical community-based setting treating children and adolescents affected by parental incarceration. Children and adolescents who experience parental incarceration are more likely to develop symptoms of post-traumatic stress disorder (PTSD): depression, anger, aggression, and isolating and self-harming behaviors. Although parental incarceration is a known source of trauma, there are no documented studies examining effective clinical treatments to reduce the effects of the trauma experienced by these children and adolescents. Except for children and adolescents affected by parental incarceration, TF-CBT, a promising model for treating and reducing the symptoms of PTSD, has been successfully applied to various populations affected by trauma. Children of incarcerated parents resemble populations treated with TF-CBT in earlier applications. In this paper, we present a case illustration that examines the application of TF-CBT with one child who experienced trauma symptoms related to parental incarceration, while discussing the results of that application and the potential for broader applicability of TF-CBT within community-based organizations that treat the population of children and families affected by parental incarceration.     

What Parents Learn From Experience: The First Child as a First Draft?

This study sought evidence for the proposition that experiences with earlier‐born adolescents will improve parents' interactions with and parenting of later‐born adolescents. Participants were mothers, fathers, and both first‐ and second‐born siblings from 392 families participating in a longitudinal study. To collect information on siblings' family experiences, family members were interviewed individually in their homes. During the subsequent 2 to 3 weeks, 7 evening telephone interviews were also conducted, which focused on siblings' daily activities. Findings suggest that when parent‐adolescent relationships were measured at the same age for both siblings, parents experienced less conflict with their second‐born as compared with their firstborn adolescent offspring and exhibited greater knowledge of their second‐born offspring's daily activities as compared with their firstborns' daily experiences. These results are consistent with the notion that parents may learn from their childrearing experiences.     

Public Assistance Use among U.S.‐Born Children of Immigrants1

U.S.‐born children of immigrants may be less likely to receive some social services than are children of native‐born parents if foreign‐born parents who are themselves ineligible are less likely to apply on their children's behalf. We use retrospective data from a sample of about 2,400 lowincome households in three U.S. cities to determine whether children with foreign‐born caregivers are less likely than children with native‐born caregivers to receive benefits from any of five programs over a two‐year period: TANF, SSI, Food Stamps, Medicaid, and WIC. The most significant disparities between children of citizen and noncitizen caregivers are in TANF and food stamp use.     

U.S. Data Sources on the Foreign Born and Immigration

Migration data can be divided into two broad types: “stock” or census and survey data and “flow” or administrative data. Both stock and flow data are valuable resources for analyzing the migration process. In the statistical system of the United States, the U.S. Census Bureau is the primary source for census and survey data on the foreign born. The Department of Homeland Security and the U.S. State Department provide several different administrative sources for studying immigration. The goal of this study is to review the best sources of government data available for analyzing (1) the size, distribution, and characteristics of the foreign‐born population and their households and (2) the level of immigration into the United States, and the distribution and characteristics of immigrants by status.     

Neural Correlates of Conflicting Social Influence on Adolescent Risk Taking

Adolescence is often characterized by heightened risk‐taking behaviors, which are shaped by social influence from parents and peers. However, little is understood about how adolescents make risky decisions under conflicting influence. The valuation system in the brain may elucidate how adolescents differentially integrate conflicting social information. Twenty‐eight adolescents (M_age = 12.7 years) completed a social influence task during a functional magnetic resonance imaging scan. Behaviorally, adolescents took more risks only when their parent endorsed risky decisions but not when their peers endorsed risky decisions. At the neural level, adolescents showed enhanced vmPFC–striatum functional connectivity when they made risky decisions that followed their parents’ risky decisions. Results suggest that parents’ decisions may guide youths’ risk‐taking behavior under conflicting influence.     

Victimization and posttraumatic stress disorder among runaway and homeless adolescents

This article presents lifetime and 12-month prevalence rates and comorbidity for posttraumatic stress disorder (PTSD) among a sample of 428 homeless and runaway adolescents. Data are from baseline interviews of a longitudinal diagnostic study of 428 (187 males; 241 females) homeless and runaway adolescents aged 16-19 years (mean age = 17.4 years, SD = 1.05). The data were collected by full-time street interviewers on the streets and in shelters in eight Midwestern cities of various populations. About one-third (35.5%) of the runaways met lifetime criteria for PTSD and 16.1% met 12-month criteria for the disorder. More than 90% of the adolescents who met criteria for PTSD met criteria for at least one of the other four diagnoses. Multivariate analyses indicated that correlates of PTSD were age of adolescent, being female, having experienced serious physical abuse and/or sexual abuse from an adult caretaker, and having been assaulted or injured by weapon when on the street. The multiplicative interaction between sexual abuse by caretaker and sexual assault when the adolescents were on their own was statistically significant, indicating that rape victims were highly likely to meet criteria for PTSD regardless of early sexual abuse. At very high levels of early sexual abuse, the probability of meeting criteria for PTSD converges with that for sexual assault victims.     

Mobility of the Foreign‐Born Population in the United States, 1995–2000: The Role of Gateway States

This study uses the 2000 PUMS to examine mobility among the foreign‐born population and the role of the gateway states. Between 1995 and 2000, net domestic migration of the foreign‐born population to gateway states was negative. Yet the rate of out‐migration from gateway states was lower than that from non‐gateway states. Overall, the findings do not support the idea that gateway states are “losing their hold” on their foreign‐born population. Yet trends in international and domestic migration are increasing the foreign‐born population of non‐gateway states relative to gateway states, and reducing differences in their characteristics.     

Personal Trauma and Risk Behaviors Among Youth Entering Residential Treatment

The focus of this study was to determine the prevalence and types of traumas experienced by adolescents prior to admission to long term mental health residential care and the impact of these traumas on their risk behaviors. The research was conducted at a state-supported residential mental health treatment facility functioning under the authority of the Department of State Health Services. Client level data was extracted from social assessment forms (N = 457) in case records of clients. Results confirmed that exposure to trauma was pervasive among adolescents admitted to the facility. Findings also revealed a link between trauma and risk behaviors among youth entering residential treatment facilities. Increased trauma exposure significantly impacted the risk behaviors of youths entering the residential treatment facility. The results indicate that the total number of traumas experienced was a greater predictor of risk behaviors among these youth than the specific traumas experienced. Internalizing behaviors such as self-harm and suicide attempts also increased with the number of traumas experienced by the adolescent. The study demonstrates the need for further exploration of the complex relationship between personal trauma, mental health, and social development in adolescents.     

The Living Arrangements of Children in Immigrant Families in the United States1

Little is known about the living arrangements of first‐ and second‐generation immigrant children. Using data from the Current Population Survey and a multivariate approach, I compared living arrangements of immigrant children to U.S.‐born white children with U.S.‐born parents. Findings show, except for foreign‐born black and some Hispanic children, that foreign‐born children lived with married parents more frequently than did U.S.‐born white children with U.S.‐born parents. However, by the third generation, a pattern emerged showing a decline in living with married parents among some immigrant children and a rise in living with single parents. The noticeable “downward assimilation” amon some second and third‐generation immigrant children fits a theory of segmented assimilation and is concerning because single‐parent families confront more social problems and sociodemographic risks.     

The Great Recession and the Allure of New Immigrant Destinations in the United States

In the 1990s, the immigrant population in the United States dispersed to non‐traditional settlement locations (what have become known as “new immigrant destinations”). This paper examines whether the allure of new destinations persisted in the 2000s with a particular focus on the internal migration of the foreign‐born during the recent deep recessionary period and its aftermath. Three specific questions motivate the analysis. First, are immigrants, much like the U.S.‐born population, becoming less migratory within the country over time? Second, is immigrant dispersal from traditional gateways via internal migration continuing despite considerable economic contraction in many new destination metropolitan areas? Third, is immigration from aboard a substitute for what appears to be declining immigrant internal migration to new destinations? The findings reveal a close correlation between the declining internal migration propensity of the U.S.‐born and immigrants in the last two decades. We also observe parallels between the geographies of migration of native‐ and foreign‐born populations with both groups moving to similar metropolitan areas in the 1990s. This redistributive association, however, weakened in the subsequent decade as new destination metropolitan areas lost their appeal for both groups, especially immigrants. There is no evidence to suggest that immigration from abroad is substituting for the decline in immigrant redistribution through internal migration to new destinations. Across destination types, the relationship between immigration from abroad and the internal migration of the foreign‐born remained the same during and after the Great Recession as in the period immediately before it.     

Policing Disaster: An Analytical Review of the Literature on Policing,Disaster, and Post‐traumatic Stress Disorder

A large body of research findings suggests that law‐enforcement officers are confronted with erratic, periodic, and unpredictable high‐stress experiences in the line of duty. There is also an increasing amount of research on police as first responders to disasters and their mental health. Recent high‐stress events, like the social disorder generated by Hurricanes Sandy and Katrina, the aftermath of the 9/11 attacks, and the violence at Newtown, created a unique matrix for stressors on police officers who may not have had much training to deal with the associated disorder or much social support to draw upon when confronting the residual emotional and mental traumas that they experienced as a result. In this context, we conduct an analytical review of the literature on police stress in instances in which officers have responded to disasters. Moreover we discuss the extant research related to rates of post‐traumatic stress disorder, the effects of PTSD and related diagnoses on the personal and professional lives of officers, and the sources of social support available to them in the aftermath of trauma‐inducing events. We conclude with a summary of current research and a critique of what is missing in the literature including attention to subclinical PTSD, proper training, the lack of attention to institutional screening for PTSD vulnerability, and the dearth of evaluation research on “what works” in disaster preparedness for police officers.     

In their own words: The life experiences of Mexican-American and white pregnant adolescents and adolescent mothers

The results of an ethnographic study of 32 Mexican-American and 17 White adolescents are presented. Fifty percent or more of the respondents in both groups experienced parental loss during their childhood years. Little information was provided by parents to the adolescents regarding menses and physical maturation. While parent-adolescent conflict arose in both samples, the conflict for the Mexican-American adolescents centered around choice of girlfriends and boyfriends while multiple sources of conflict existed between the White respondents and their parents. White respondents were more sexually active than the Mexican-American respondents, but the latter reported more stable relationships with the father of the baby. The experiences of the adolescents are both summarized and presented in their own words.     

Educational Attainments of Immigrant Offspring: Success or Segmented Assimilation?1

In this article, I study the educational attainments of the adult offspring of immigrants, analyzing data from the 1996 panel of the Survey of Labour and Income Dynamics (SLID). Fielded annually since 1993 by Statistics Canada, respondents are asked for the first time in 1996 to report the birthplaces of their parents, making it possible to define and study not only the foreign‐born population (the first generation), but also the second generation (Canadian born to foreign‐born parents) and the third‐plus generation (Canadian born to Canadian‐born parents). The survey also asked respondents to indicate if they are members of a visible minority group, thus permitting a limited assessment of whether or not color conditions educational achievements of immigrant offspring. I find that “1.5” and second generation adults, age 20–64 have more years of schooling and higher percentages completing high school compared with the third‐plus generation. Contrary to the segmented “underclass” assimilation model found in the United States, adult visible minority immigrant offspring in Canada exceed the educational attainments of other not‐visible‐minority groups. Although the analysis is hampered by small sample numbers, the results point to country differences in historical and contemporary race relations, and call for additional national and cross‐national research.     

Traumatic Experiences in Childhood and Adult Substance Use in a Nonclinical Sample: The Mediating Role of Arousal/Reactivity

The vast majority of adults in the United States experience at least one traumatic event during childhood. According to the self‐medication hypothesis of substance use disorders, adult survivors of childhood trauma may cope with trauma‐related symptoms via alcohol or drug use. The purpose of this study is to identify through which specific PTSD symptom clusters childhood trauma exposure are associated with adult substance use. Participants of this study (N = 627) were not recruited based on substance use or traumatic exposure. Results of this study demonstrate that arousal/reactivity partially mediates the association between childhood trauma and current substance use. Implications for treatment include recommendations for trauma‐informed approaches that aim to decrease arousal/reactivity and subsequently substance use.     

CREATING HEALING RELATIONSHIPS FOR COUPLES DEALING WITH TRAUMA: THE USE OF EMOTIONALLY FOCUSED MARITAL THERAPY

Emotionally focused marital therapy (EFT), a marital therapy that particularly focuses on the creation of secure attachment, has proven in empirical studies to be effective for distressed couples. This paper discusses the application of EFT in couples where one or both of the partners have experienced significant trauma. EFT, in this context of trauma, incorporates the nine steps of conventional EFT and also encompasses the three stages of the "constructivist" self development theory of trauma treatment. This paper illustrates how the integration of EFT and trauma treatement can prove effective in treating not only relationsip distress but also the individual symptoms of posttraumatic stress disorder (PTSD).     

Interpersonal trauma and associated psychopathology in girls and boys living in residential care

Out-of-home placement in e.g. residential care is the most common intervention for children and adolescents at risk and studies have shown that this population exhibits high prevalence rates of traumatic events. Associations with specific psychopathology need to be studied in order to sensitize caregivers to the specific needs of this population. The present study aimed to assess the relationship between interpersonal traumatic experiences and specific psychopathological symptoms in a high-risk population of girls and boys living in youth welfare institutions in residential care. 370 adolescents living in 64 different Swiss institutions and their professional caregivers filled out questionnaires on traumatic experiences and psychopathology and took part in structured clinical interviews. They were grouped in 3 different subgroups: no interpersonal trauma, single interpersonal trauma and multiple interpersonal trauma, i.e. interpersonal trauma in two or more domains. Furthermore, associations between the identity of the perpetrator (if the perpetrator was known vs. unknown to the victim) and psychopathology were examined. One third of participants reported multiple interpersonal trauma with female adolescents being more often affected. Multiple interpersonal trauma was associated with more internalizing and externalizing symptoms, but this association was only found with self-reported psychopathology. Male adolescents with multiple interpersonal trauma seemed to be more vulnerable to substance use and affective disorders, while female adolescents with multiple interpersonal trauma tended to have disorders of attention, activity and conduct disorders. Interpersonal trauma (compared to no interpersonal trauma) was not associated with higher rates of PTSD. Furthermore, associations between interpersonal trauma and psychopathology were stronger when the perpetrator was known to the victim.Our results suggest that interpersonal trauma, especially multiple interpersonal trauma, seem to be associated with mental health problems beyond the symptoms of PTSD in this high-risk population. Concepts of residential care institutions should contain trauma-sensitive care and include psychiatric liaison services in order to take into account the specific needs of adolescents in residential care.     

Racial Discrimination, Post Traumatic Stress, and Gambling Problems among Urban Aboriginal Adults in Canada

Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events.     

"Everyone with Eyes Can See the Problem": Moral Citizens and the Space of Irish Nationhood

This paper examines Ireland's 2004 Constitutional Amendment which removes birthright citizenship from any future Irish‐born children of immigrant parents. I argue that for particular historical reasons, the ability of the state to convince its citizens of the necessity for this Amendment was remarkable and I suggest that it was able to do so by constructing citizenship as a moral regime and foreign‐nationals and their foetuses as ‘suspect patriots.’ I describe how the notion of immorality is laminated upon black bodies — specifically black pregnant women — and how the presence of black migrant workers, refugees and asylees consequently comes to be experienced in Irish national space as transgressive, their political subjecthood constrained by the supposedly legible abjectivity of their bodies. The issue of race remains unenunciated, and yet, as the Minister for Justice stated during the referendum debate, ‘anyone with eyes can see the problem.’ The Irish government's privileging of moral rather than cultural incommensurability is strikingly similar to culturalist rhetorics of exclusion that are often invoked when race is at issue in European public debate on immigration. Configured upon, and therefore experienced as a type of body, immorality becomes an alibi for race and is naturalized as a form of exclusion and as a potential site of state intervention in the form of xenophobic legislation and policymaking. Reading this decision as merely racist however, fails to give voice to the experiences of Irish Citizens who voted for this Amendment. Their struggle to build a “New Ireland” and to accept a multiculturalist framework in the face of neo‐liberal restructuring policies and a European‐wide retreat from the welfare state must be considered as being in dialectical tension with the ideological smearing of immigrants if we are to fully grasp the complex interaction between relations of power and the privileging of difference.